Question
Hi Dr. Katz,

Thank you for taking the time to read this.

6 weeks ago I had cryosurgery. Treated was a neuroma in my left foot between 3rd & 4th metatarsals.
The treatment differed from what I saw on your website in that the incision was on the top of my foot and he did 3 freeze cycles.

At this point, there is still so much inflammation & pain in response to the procedure that I can't bear weight on my left foot and it is painful even at rest.
I had no idea that this was a possibility.
I had an MRI a little over a week ago that confirmed edema, inflammation, etc of soft tissue, muscle, etc post cryo.  
MRI does not show neuroma, but MRI 6-7 months ago didn't show either.
Neuroma was confirmed by ultrasound 5 months ago.

What is your prognosis for at least getting back to where I was prior to the procedure?
How much time to give it before trying something else? or 2nd cryo?

History in a nutshell:

I am 47 year old female, very healthy & had been very active.
A year ago, I got orthotics from a biomechanics doc that a friend recommended.  After wearing them for about 2 weeks, I went for a walk & by the end of the walk, I was needing to walk on the edge of my left foot to get home.  Some sort of trauma had occurred during that walk with the orthotics (my personal theory is that they had a sort of slippery surface and that my foot was sliding laterally as I walked).  I got the orthotics because I had been dealing with neuroma pain for 3-4 years that only happened when I went hiking.
At that point, I started to have pain all the time, unable to hike, walk far without increasing pain.
2 cortisone shots: no improvement.
Acupuncture, ultrasound, stim, taping: no improvement
Alcohol injections, 4 of them: no improvement.
Then about 3 weeks after the last alcohol injection, I had cryosurgery (6 weeks ago).
My foot is now about 5 times worse than it was prior to cryo.
Four days ago started Medrol, Flector, rest etc. and advised against doing any surgery in the near term (which I have been trying to avoid anyway, but at this point I want my life back).  I am doing that and wearing cam walker to try to give my foot the opportunity to calm down.  So far, no improvement.

Ruth

Answer
Hi Ruth,

It is unusual to have pain after cryosurgery at 6 weeks.  However, in some cases there can be no relief or short-lived pain.  MRI does not always show a neuroma and depends on the technician and the reading radiologist.  Of course an MRI after the procedure will show inflammation from the surgery and injury to the area.  There are several possible causes of your pain.  You may have had only partial freeze of the nerve which increases nerve pain until the nerve heals.  Other possible causes may be damage to the muscle leading to internal bleeding and inflammation.  I would consider having physical therapy to rehab the foot.  

Also another consideration is that you never had a neuroma.  

I've used all cryosurgery approaches for neuroma and have that between the toes is superior.  Also there is much greater accuracy with color doppler ultrasound guidance or CryoMax.  See my site below.

Sincerely,

Marc Katz, DPM
Tampa, FL
Advanced Podiatry
www.thetampapodiatrist.com
www.tampacryosurgery.com

DISCLAIMER:
This information is offered as free advice and as general information. It may not be applicable to the specific questioner and his/her problem.  It is not based on actual knowledge of the questioner or his/her medical history and it cannot and should not be relied upon as definitive medical opinion or advice.  Reliable medical opinion and advice can only be obtained through hands-on physical contact and exam of the patient to establish an accurate diagnosis and treatment plan.  No doctor/patient relationship is created or established here and may not be inferred through answers on this site.  The questioner and other readers must consult his/her own doctor before proceeding or implementing any suggestions contained within this document and answers on this site.  The questioner is only to act upon his/her own doctor抯 orders and recommendations. By reading this posting which follows, the reader fully understands and confirms that he/she holds harmless this writer. If this is not fully agreeable to you, the reader, and/or you have not attained the age of 18 years, you hereby are advised to read no further.